Definition

Stuttering is a speech disorder in which the flow of speech is interrupted by:

  • Repetition or prolongation of sounds, words, or syllables
  • An inability to begin a word

The person who is stuttering may frequently blink the eyes and/or have abnormal facial or upper body movements in an attempt to speak.

Causes

The cause of stuttering is still incompletely understood. Some experts have suggested that stuttering may occur when:

  • A child's ability to speak does not match his or her verbal demands
  • There are psychological factors in a child’s life, such as mental illness or extreme stress
  • Problems occur in the connections between muscles, nerves, and areas of the brain that control speech

Considerable current evidence suggests that stuttering is caused by problems in the part of the brain which controls the timing of speech muscle activation. The reasons for such problems of speech timing remain unclear.

Muscles and Nerves Involved in Speech

Tongue Innervation

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Risk Factors

A risk factor is something that increases your chance of getting a disease or condition.

  • Family history of stuttering
  • Sex: male
  • Age: between 2 to 6 years of age

Symptoms

Symptoms may include:

  • Repetition of sounds, syllables, words, or phrases
  • Prolongation of sounds within words
  • Between-word pauses and lack of sound
  • "Spurting" speech
  • Accompanying behaviors, such as:
    • Blinking
    • Facial ticks
    • Lip tremors
    • Tense muscles of the mouth, jaw, or neck
  • Worsening symptoms when speaking in public
  • Improvement in symptoms when speaking in private

Diagnosis

The doctor will ask about your symptoms and medical history, and perform a physical exam. Diagnosis may be based on:

  • Stuttering history
  • Circumstances under which stuttering occurs
  • Speech and language capabilities
  • Evaluation of hearing and motor skills, including a general pediatric and neurological examination.

You or your child will likely be referred to a speech language pathologist for further evaluation or treatment.

Treatment

There is no cure for stuttering. However, treatment may dramatically improve stuttering. The main goal of treatment is to establish and maintain a feeling of control over speech fluency. Recovery rate is approximately 80%, more in girls than in boys.

The doctor or speech therapist can evaluate the stuttering pattern and assess what strategies may work best. Possibilities may include:

Drug Therapy

As yet little evidence supports the use of drugs to improve speech fluency.

Behavioral Therapy

This treatment often focuses on behavioral modifications that can be made to improve fluency.

Speech Therapy

A primary goal of this type of therapy is to slow the rate of speech.

There is currently not enough evidence to establish which form of treatment for stuttering is most effective.

Prevention

There are no guidelines for the prevention of stuttering. However, early recognition and treatment may minimize or prevent a life-long problem.